Drug Features Generis Name: Co-amoxiclav rand Name: Augmentin, Clavamox Drug class: Antibiotic, Aminopenicillin, Beta-lactam (Beta-Lactam

and Beta-Lactamase Inhibitor Combination) !regnanc" Categor": B #riginall" disco$ered: 19 , Beecham !esearch Laboratories, "nited #ingdom Time to Clear out in the bod" s"stem: $he hal%-li%e o% amoxicillin a%ter the oral administration o% Augmentin is 1&' hours and that o% clavulanic acid is 1&( hour& #$er Dosage: )a* be treated s*mptomaticall* +ith attention to the +ater

Therapeutics Indication Contraindication ,istor* o% penicillin acterial h*persensitivit* infections of the -uper in%ections upper respirator" involving .seudomonas tract (nasal or candida passages, sinuses .regnanc*/ lactation etc&) e&g& sinusitis& acterial infections of the lower respirator" tract (lungs, air+a*s) e&g& bronchitis, pneumonia& acterial infections of the ears% nose or throat, e&g& otitis media, tonsillitis& acterial infections of the urinar" tract or &idne"s, in particular recurrent c*stitis& acterial infections of the s&in and soft tissue, e&g& cellulitis, animal bites& Dental abscesses& acterial infections of bones or 'oints, e&g& osteom*elitis& acterial infections of the genital organs%

Desired Inhibits en0*mes involved in %ormation o% peptidogl*can la*er o% bacterial cell +all 1o e%%ect on human cell +alls Bactericidal2 onl* +or3s on dividing bacteria 4ell absorbed enterall* Clavulanic acid inhibits bacterial5lactamase

Effects Untoward Gastrointestina l reactions 6 7iarrhea, indigestion, nausea, vomiting, and mucocutaneous candidiasis have been reported& Antibioticassociated colitis (including pseudomembranous colitis and haemorrhagic colitis) has been reported rarel*& 1ausea, although uncommon, is more o%ten associated +ith higher oral dosages& (uperficial tooth discolouration has been reported rarel*, mostl* +ith the suspension& It can usuall* be removed b* brushing& Renal and urinar" tract disorders6 Cr*stalluria has been reported ver* rarel*& Genito)urinar" effects6

Nursing Responsibilities -ta* at the patient bedside during drug inta3e to insure that the patient ta3e the medicine& !endered health teaching such as6 patient instructed to6 does not share medicine +ith other patient2 report signs o% allergies or an* unusualities& discuss some adverse e%%ect o% drug .regnanc* ,istor* o% h*persensitivit* !enal impairment ,epatic impairment 8 ma* cause cholestatic 9aundice up to : +ee3s a%ter cessation )a* cause maculo papular rashes - almost al+a*s in presence o% glandular %ever I% gastrointestinal side e%%ects occur +ith oral therap* the* ma* be reduced b* ta3ing Coamoxiclav at the start o% meals& Co-amoxiclav ma* reduce the e%%icac* o% oral contraceptives and patients should be +arned accordingl*& Antibiotics such as coamoxiclav ma* alter the e%%ect o% anticoagulants such as +ar%arin& Co-amoxiclav in9ection should N#T be mixed or reconstituted +ith dextrose

electrol*te balance& Coamoxiclav ma* be removed %rom the circulation b* haemodial*sis& Gi$en to patient: :;< mg, =1;

including those following childbirth or abortion& acterial infections inside the abdomen, e&g& peritonitis& !re$enting infections following surger" (b* in9ection)&

>aginal itching, soreness and discharge ma* occur& *epatic effects6 )oderate and as*mptomatic rises in A-$ and? or AL$ and al3aline phosphatases have been reported occasionall*& ,epatitis and cholestatic 9aundice have been reported rarel*& Contraindicated +ith h*persensitivit* +ith me%enamic acid& "se cautiousl* +ith asthma, renal or liver d*s%unction, peptic "lcer disease, gastrointestinal bleeding , h*pertension, C,B, pregnanc* and lactation& -hould not be given to patients +ho have experienced asthma, urticaria, or allergic-t*pe reactions a%ter ta3ing aspirin or other 1-AI7s& (-evere, rarel* %atal, anaph*lactic-li3e Anti in%lammator* Analgesic Antip*retic Activities related to inhibition o% prostaglandin s*nthesis Axact mechanism o% action is not 3no+n& CN(: ,eadache, di00iness, somnolence, insomnia, %atigue, tirednes s, tinnitus, ophthalmic e%%ects& Dermatologic: rash, prumitus, s+eating, dr* mucous membranes, stomatitis GI: d*suria, renal impairment *ematologic6

solution, sodium bicarbonate solution %or in9ection, protein h*drol*sates and other proteinaceous %luids, blood or plasma or +ithintravenous lipid emulsions& I% co-amoxiclav is prescribed concurrentl* +ith an aminogl*coside, the antibiotics should not be mixed in the s*ringe, intravenous %luid container or giving set because loss o% activit* o% the aminogl*coside can occur under these conditions&

Generic Name: )e%enamic acid rand Name: .onstel, 7ol%enal, A.@-)e%enamic Acid% .)--)ABA1A)IC )ABA1A)IC ACI7 .@1-$A1 Drug class6 Anti 8 in%lammator*, Analgesic, Antip*retic activities related to inhibition o% prostaglandin s *nthesis

Relief of moderate pain +hen therap* +ill not exceed one +ee3& $reatment o% primar* d"smenorrhea

-ta* at the patient bedside during drug inta3e to insure that the patient ta3e the medicine& !endered health teaching such as6 patient instructed to6 does not share medicine +ith other patient2 report signs o% allergies or an* unusualities& discuss some adverse e%%ect o% drug Cive drugs +ith %ood or mil3 to decrease gastrointestinal upset& In%orm patient not to use drug %or longer than 1 +3& I% given %or d*smenorrhea, instruct patient to begin ta3ing drug +ith onset o% bleeding and associated s*mptoms&

reactions to 1-AI7s have been reported in such patients&) Contraindicated %or the treatment o% perioperative pain in the setting o% coronar* arter* b*pass gra%t (CABC) surger* Contraindicated in patients +ith acute active ulceration or chronic in%lammation o% either the upper or lo+er gastrointestinal tract& -hould not be used in patients +ith preexisting renal disease&

bleeding, platelet inhibition in higher doses, neutropenia, eosinophilia, leu3openia, panc*tonea, thromboc*topenia, agranaloc*tosis, granaluc*topenia, aplastic anemia, decrease ,gb @! hC$, bone marro+ depression,menorrh agia& Respirator"6 d*spnea, hemopt*sis, phar*ngitis, bronchospasm, rhinitis

4arn patient about potential %or bleeding, and advise patient to noti%* other health care pro%essionals that drug is being ta3en& Instruct patient to report the %ollo+ing s*mptoms to health care provider6 rash, visual problems, dar3 stools, decreased urinar* output, persistent headache or stomach pain and unusual bruising or bleeding& Advise patient to avoid inta3e o% alcoholic beverages& Instruct patient that drug ma* cause dro+siness and to use caution +hile driving or per%orming other activities re=uiring mental alertness& Caution patient to avoid prolonged exposure to sunlight and to use sunscreen or +ear protective clothing to avoid photosensitivit* reaction& Instruct patient not to ta3e @$C medications, including aspirin and ibupro%en or other prescription drugs, +ithout consulting health care provider& -ta* at the patient bedside during drug inta3e to insure that the patient ta3e the medicine& !endered health teaching such as6 patient instructed to6 does not share medicine +ith

Generic Name: Berrous Bumarate rand Name: Berretts, ,emoc*te, Bemiron, Beostat, Ircon

Iron de%icienc* anemia& .regnanc*

Contraindicated in conditions li3e Chic3enpox in%ection,In%luen0a& .atients should not have %errous %umarate i% he

Increased production o% red blood cells and reduction o% s*mptoms associated +ith anaemia

gastrointestinal irritation constipation +hich ma* lead to %aecal impaction nausea

or she has6 anaemia due to vitamin B1; de%icienc* (pernicious anaemia)& anaemia due to %olic acid de%icienc*& Cenetic disease resulting in too much iron storage in the tissues (haemochromatosis)& disorder that a%%ects storage o% iron in the bod* (haemosiderosis)& a condition +here there is sudden loss o% haemoglobin (ox*gen carr*ing protein in the blood) in the urine at night (parox*smal nocturnal haemoglobinuria)& other disorders involving haemoglobin, such as sic3le cell anaemia or thalassaemia& receiving repeated blood trans%usions& active peptic ulcer& In%lammator* bo+el disease such as ulcerative colitis or CrohnDs disease

such as +ea3ness and shortness o% breath&

stomach pain diarrhoea dar3 coloured stools blac3 discolouration o% the teeth - this has been reported to occur +ith the li=uid %orm o% this medicine

other patient2 report signs o% allergies or an* unusualities& discuss some adverse e%%ect o% drug Instruct patient to ta3e %errous %umarate on an empt* stomach %or best results& I% stomach upset occurs, ta3e %errous %umarate +ith %ood or %ollo+ing a meal&
In%orm patient not to ta3e large doses o% vitamins (megadoses or megavitamin therap*) unless other+ise directed b* *our doctor& In%orm patient not to ta3e Berrous Bumarate %or longer than : months +ithout chec3ing +ith *our doctor& Instruct patient to have LAB $A-$-, including blood tests and iron levels, to monitor *our progress or to chec3 %or side e%%ects&&